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Lung Cancer Center

About Us

At Cleveland Clinic Florida, a highly specialized team of physicians cooperates to provide lung cancer patients with coordinated diagnosis and innovative treatment plans. Employing a multidisciplinary approach to manage and treat patients with lung cancer, pulmonologists (lung specialists), pathologists (tissue diagnostic specialists), medical and radiation oncologists (cancer treatment specialists), thoracic (chest) surgeons, and pain management experts collaborate to offer a full spectrum of diagnostic and therapeutic services.

Multidisciplinary Clinic

The complexity of lung cancer treatment requires input from various experts skilled in different medical specialties. For this reason, Cleveland Clinic Florida created a Multidisciplinary Clinic which provides a unique service to patients and increases communication with physicians.

Through the Multidisciplinary Clinic, a number of specialists from a variety of disciplines, including Pulmonary Medicine, Hematology/Oncology, Robert and Suzanne Tomsich Department of Cardiac Surgery, Pathology, Radiology and Pain Management, collaborate with each other to ensure that patients receive the best possible treatment.

Patients can schedule an appointment to meet with experts from various specialties, all at the same time. This team approach to patient care also increases communication among physicians, which facilitates the speed and quality of the patient’s treatment.

The Multidisciplinary Clinic’s appointment line is staffed by a nurse who is a lung cancer specialist, which gives patients the opportunity to ask questions when they call to make an appointment.

To request an appointment at the Multidisciplinary Clinic, please call 954.659.5700.

Treatment Outcomes

Cleveland Clinic Florida is committed to achieving the best possible outcomes through quality medical care using state-of-the-art technologies and innovative treatments.

One of the best ways to determine the quality of medical care is to measure patient outcomes by diagnosis or procedure. Each year, we compile a detailed report of results, trends and treatment approaches for each medical specialty. Outcomes books contain a summary of our surgical and medical trends and approaches, data on patient volume and outcomes, and a review of new technologies and innovations.

Treatment Guide

What Is Lung Cancer?

Lung cancer is the second most common form of cancer in the United States and the leading cause of cancer deaths. More women die of lung cancer than of breast cancer. While the rate of lung cancer cases appears to be dropping among Caucasian and African-American men, it continues to rise among both Caucasian and African-American women. Ninety percent of lung cancer cases are caused by cigarette, pipe or cigar smoking.

Lung cancer results when abnormal cell growth invades and destroys normal lung tissue. An accumulation of abnormal cells is called a tumor. As a tumor grows, it impairs lung function, resulting in breathing difficulty and decreased oxygen in the blood.

Diagnosing Lung Cancer

Cleveland Clinic Florida offers a number of testing procedures to diagnose lung cancer. To help find the cause of symptoms, doctors will evaluate patients’ medical history, smoking history, exposure to environmental and occupational substances and family history of cancer. Doctors will also conduct a physical exam and order a variety of tests.

Diagnostic Imaging
X-Ray

If lung cancer is suspected, the doctor may order a chest X-ray as a first step in diagnosis, which may indicate a mass in the lungs or enlarged lymph nodes. If chest x-ray is normal, additional tests may be conducted if lung cancer is suspected. Because every mass is not cancerous, the additional tests may still be performed.

Computer Assisted Tomography (CT) and Magnetic Resonance Imaging (MRI)

Frequently, a CT scan or an MRI will be performed as a follow-up to an abnormal chest X-ray or to evaluate abnormal symptoms in patients with a normal chest X-ray. CT scanning involves a series of X-rays that create a 3-D view of the lungs, while MRI uses powerful magnets and radio waves to read the signals created by different types of tissues. Both can show the size, shape and location of a tumor. They are very useful tools in determining whether or not the tumor has spread from the lung to other parts of the chest or to other parts of the body.

Positron Emission Tomography (PET) Scans

During a PET scan a very small dose of radioactive chemical, called a radiotracer, is injected into a vein in the arm. The radiotracer travels through the body and is absorbed by the organs and tissues. A scanner detects and records the energy given off by the tracer substance. A PET scan can measure such vital functions as blood flow, oxygen use, and glucose metabolism, which helps doctors identify abnormal from normal functioning organs and tissues.

Integrated PET-CT Scans

A PET-CT scan combines the images from both a PET and a CT scan. As the PET scanner detects signals of actively growing cancer cells in the body, the CT scan creates a three-dimensional picture of the internal anatomy that reveals the location, size and shape of abnormal cancerous growths. The two scans are performed at the same time and on the same machine, creating a more complete image of tumors or any abnormalities.

Autofluorescence Bronchoscopy

Autofluorescence Bronchoscopy is a special light that is used inside the lung through a small scope. This light is able to detect suspicious areas of possible cancer in the bronchia tubes that are not clearly seen by standard bronchoscopy.

Biopsy and Tissue Sampling

If diagnostic imaging tests are abnormal, tissue sampling may be conducted to confirm a diagnosis. The doctor may examine mucus in the lungs and will examine tissue from the lung to see if cancer cells are present. A number of procedures may be used to obtain tissue for biopsy.

Sputum Cytology

Sputum cytology is a simple test in which the doctor obtains a sample of the mucus in the lungs to examine microscopically. Because it cannot pinpoint the tumor's location, a positive sputum cytology test is usually combined with imaging tests and a tissue biopsy.

Endobronchial Ultrasound (EBUS)

EBUS is a technique where a special, very small scope, with a tiny ultrasound at the tip allows the pulmonologist to perform biopsies in multiple areas. This allows the specialist to minimize the risk of puncturing a blood vessel and allows for better accuracy, since they can see that the needle is placed inside the abnormality with the ultrasound.

Esophageal Ultrasound (EUS)

EUS is a special technique, where a special, scope, with a tiny ultrasound at the tip of the scope allows the physician to perform biopsies in multiple areas. This allows the specialist to minimize the risk of puncturing a blood vessel and allows for better accuracy, since we can see that the needle is placed inside the lesion with the ultrasound.

Transbronchial Needle Aspiration Biopsy

Transbronchial Needle Aspiration Biopsy uses a small scope to go to distant areas in the lung where a small biopsy forceps is used to remove tiny pieces of lung to make the accurate diagnosis of lung conditions in the outpatient setting.

Transtracheal Needle Aspiration Biopsy

EUS is a technique where a special, very small-sized scope, with a tiny ultrasound at the tip allows the pulmonologist to perform biopsies in multiple areas. The lesion is visualized by fluoroscopy (live x-ray) or by bronchoscopy. This allows the specialist to minimize the risk of puncturing a blood vessel and allows for better accuracy, as they can see that the needle is placed inside the area of concern with the ultrasound.

Flexible Biopsy Techniques

Biopsy procedures are performed with very small scopes using sedation techniques that keep patients very comfortable and asleep.

Percutaneous Needle Biopsy

Chest radiologists perform computerized guided biopsy of tumors at multiple areas in the chest reducing the need for surgical biopsies to make a diagnosis. Those procedures are done on an outpatient basis with the patient going home the same day.

Ultrasound Guided Thoracentesis

Ultrasound Guided Thoracentesis removes abnormal fluid from the pleural space between the lung and the chest wall using ultrasound.

Interventional Radiology
CT Guided Biopsy

A CT Guided Lung Biopsy uses real-time CT images to ensure biopsy samples are accurately taken from the desired part of the lung. These biopsy samples are check for adequacy by a pathologist during the procedure to make sure a diagnostic sample is obtained.

Vascular Access

A vascular access procedure involves the insertion of a flexible thin plastic tube, or catheter, into a blood vessel to provide a painless way of collecting blood samples for analysis.

Port Placement

A port is a device that allows an easy and reliable way to take blood samples from the veins. The port is implanted under the chest skin and a catheter is connected to it. The catheter is tunneled under the skin to an area near the neck where it enters a vein.

Minimally Invasive Surgery
Video assisted thorascopic surgery (VATS)

Video assisted thorascopic surgery is a minimally invasive surgical procedure used to diagnose and stage lung cancer as well as remove cancerous and benign tumors. During VATS a tiny camera with a light source is inserted through a small incision in the ribs. A second small incision is used to insert special instruments between the ribs and into the chest cavity.

Lung Cancer Treatment Options

Surgery, radiation therapy, and chemotherapy are used to treat lung cancer. Cleveland Clinic Florida provides patients with the latest surgical and non-surgical treatment options. Treatment is based on the type and stage of the patient’s cancer, where the tumor is located and the patient’s overall health. Cleveland Clinic Florida’s medical experts offer surgical and non-surgical options.

Non-Surgical Treatment Options
Radiation Oncology

Cleveland Clinic Florida offers radiation therapy that directly targets a tumor with high-energy x-rays to destroy cancer cells.

Chemotherapy

Chemotherapy is a type of cancer treatment that uses medication to destroy cancer cells. It is also used to stop, slow the growth or shrink cancer cells. Chemotherapy is often administered through catheters and ports.

State of the art infusion unit

Cleveland Clinic Florida’s state of the art infusion unit is available for chemotherapy and biologics treatments. The infusion unit is fully staffed with highly trained oncology doctors, nurses and pharmacists and features semi private areas with individual televisions.

Laser Bronchoscopy for tumor destruction

Laser Bronchoscopy uses a laser to destroy airway tumors or lesions as well as eliminate obstructions in the bronchial tubes that cause shortness of breath.

Airway Stent placement for narrowing of the airway

Stents are small cylindrical expandable tubes, very similar to the types used by cardiologists to open up arteries in the heart. They are used to open bronchial tubes that are occluded or narrowed due to infection, tumors or scar tissues.

Electrocautery bronchoscopy for destruction of lesions and removal of polyps

Electrocautery bronchoscopy uses electric currents to destroy benign and malignant tumors in the bronchial tubes. It also helps to open up obstructed airways and to stop bleeding.

Argon plasma coagulation

Argon Plasma coagulation uses mild electric currents to destroy benign and malignant tumors in bronchial tubes, open up obstructed airways, and stop bleeding.

Balloon dilation for tracheal and bronchial stenosis

Balloon dilation for tracheal and bronchial stenosis uses small balloons to dilate bronchial tubes. The procedure passes the balloons through small bronchoscopes. The procedure is similar to angioplasties performed by cardiologists, except that it is done on the bronchial tubes.

Photodynamic therapy

Photodynamic therapy uses an injection of a special chemical in the blood that is absorbed by cancer cells in the lungs. After the chemical is given, special light is used to activate the chemical absorbed inside the tumor cell, destroying the tumor cell but not affecting the healthy ones. This can be very useful in early stages of cancer to prevent further growth.

PleurX catheter placement

This treatment involves placement of a pig-tail catheter in the pleural spare when fluid continues to re-accumulate, especially in patients with malignant pleural effusions.

Brachytherap

Brachytherapy places a small catheter in the lung so radiation can be given inside the bronchial tube. This is utilized in patients with central tumors or tumors inside the airway, as well as patients who have received large doses of external radiation.

Cryotherapy

Cryotherapy uses cold energy and freezing temperatures to treat bronchial lesions.

Foreign body aspiration or inhalation and removal

Foreign body aspiration and removal removes accidentally inhaled foreign bodies such as food, insects and others from the airway with little baskets or other tools

Surgical Treatment Options
Pleuroscopy

This is a procedure similar to laparoscopy but when performed in the chest, it is called pleuroscopy or video thoracoscopy. A small instrument with a camera is inserted into the chest cavity through a very small incision allowing the physician to do diagnostic and therapeutic procedures inside the chest.

Lobectomy

A lobectomy is the surgical removal of a large section of lung. It is the most common surgery performed to treat lung cancer. Lobectomy has been traditionally performed during thoracotomy surgery. During thoracotomy surgery, an incision is made on the side of the chest between the ribs. The ribs are then spread apart so the surgeon can see into the chest cavity and remove the tumor or affected tissue.

Mediastinoscopy

A mediastinoscopy is a surgical procedure that allows the surgeon to examine the inside of the upper chest between and in front of the lungs (mediastinum). A small cut is made in the neck just above the breastbone or on the left side of the chest next to the breastbone. Then a thin scope (mediastinoscope) is inserted to remove tissue for biopsy or to examine and evaluate tumors in the middle chest.

Video Assisted Thorascopic Surgery (VATS)

Video-assisted lobectomy is less invasive than traditional thoracotomy. During VATS lobectomy, three 1-inch incisions and one 3- to 4-inch incision is made in the chest to provide access to the chest cavity without spreading the ribs. A thorascope (small video camera) and surgical instruments are inserted into the incisions. Images transmitted by the thorascope and projected onto a computer monitor guide the thoracic surgeon while performing the lobectomy. While the outcomes are comparable to traditional lobectomy, this technique reduces a patient’s hospital stay to about 3 to 4 days and the patient experiences a more rapid recovery with less pain. Cleveland Clinic is one of the few centers in the nation with significant experience in video-assisted thorascopic surgery.

Sleeve Resection

This is a surgical procedure to remove the cancerous part of the lung and part of the bronchus (airway) attached to it. The ends of the remaining bronchus are rejoined and reattached to the remaining lobe. This procedure spares the healthy portion of the lung.

Limited or Wedge Resection

A limited or wedge resection is a surgical procedure to remove a wedge-shaped portion of the lung, including the tumor and a surrounding margin of healthy tissue. This procedure is performed as an alternative to lobectomy.

Pneumonectomy

A pneumonectomy removes one whole lung when the cancer cannot be treated by removing a smaller portion.

Smoking Cessation Program

According to the 2004 Surgeon General’s Report, most cases of lung cancer are due to cigarette smoking. Patients who have been diagnosed with lung cancer or those who wish to end their nicotine addiction can work with professionals at Cleveland Clinic Florida’s Smoking Cessation Program to quit smoking.

Cleveland Clinic Florida’s Smoking Cessation Program uses the S.M.A.R.T. Quit approach to help patients overcome nicotine addition. The S.M.A.R.T. approach is as follows: Strategy: Develop a program tailored for each patient’s success. Motivation: Encourage patients to make a pact with themselves to keep trying. Awareness: Teach patients about nicotine addiction, withdrawal and triggers. Reasons: Help patients compare pros and cons and identify their top reasons to quit. Tobacco-Free Life: Help patients set a date; then commit to living without tobacco.

How the program works

A Cleveland Clinic Florida certified smoking cessation specialist l helps patients understand nicotine addiction and how to quit. The specialist develops a personalized treatment plan that includes one-on-one support and a variety of resources. The smoking cessation program runs 3 to 6 months and meets biweekly and monthly.

Though everyone’s addiction is unique, a combination of behavioral therapy and medication has been proven to dramatically increase the chance of success. Research from Pfizer reports a 44% quit rate in 12 to 6 weeks.

Treatment programs may include:

  • Prescribed medications
  • Over-the-counter medications
Alternative treatment options

Acupuncture
Because each person’s smoking habit is unique, every treatment is personalized. Treatments focus on the physical and emotional withdrawal symptoms that may arise, and also aid in relaxation. Hair-thin needles are superficially inserted into a combination of points in the ears and body believed to influence organs and energetic pathways associated with smoking. Targeting these acupuncture points calms the mind and reduces withdrawal symptoms and nicotine cravings.

Laser Therapy
A drug-free, non-invasive treatment in which a laser is used to target energy points throughout the body, causing the release of serotonins and endorphins. Laser therapy helps detox the body, flushing out harmful substances, and reduces the craving for nicotine.

Hypnosis 
A treatment intervention that induces the client into a relaxed state. The clinician then provides post-hypnotic suggestion for relief from symptoms. A trance is a natural occurring state, so anyone can be hypnotized. Only a light to medium state of hypnotic trance is necessary for effective therapy.

  • Behavioral therapy
  • Reading material
  • Web-based programs
  • Individual or group counseling

Patients should contact their insurers to find out of smoking cessation is a covered benefit. For more information on Cleveland Clinic Florida’s smoking cessation program or to talk with a specialist about quitting, please call: 954.659.5978. To enroll, patients need a prescription for Smoking Cessation (SC) from their physician.

To schedule a consultation or appointment, call 954.659.5978.

Our Staff

Cleveland Clinic Florida’s unique model of medicine brings together a multidisciplinary team of specialists to provide patients the best treatment options and care.

Research & Clinical Trials

Clinical research has been fundamental to the mission of Cleveland Clinic since its establishment. At Cleveland Clinic Florida, our robust research program is designed to provide patients with the most up to date treatment options.

At any given time, patients can participate in a number of leading-edge research trials to test new drug therapies and investigate new treatment protocols. Clinical trials rely on the participation of human volunteers to answer questions about treatments for diseases and conditions.

In general, clinical trials are used to test the safety and effectiveness of drugs and medical procedures in a human population. This ongoing collaboration between physician investigators and study volunteers is one of the foundations of modern healthcare, because clinical trials help set the standards for patient care.

There are potential benefits, for clinical trial volunteers. Volunteers with existing diseases or conditions can play a more active role in their own healthcare, gain access to new research treatments before they are widely available, and help others by contributing to medical research.

Today, Cleveland Clinic Florida is participating in many clinical trials of various types.

Support Services

Patient Family Support Services

It is often difficult when a patient or their loved one is diagnosed with lung cancer. Cleveland Clinic Florida offers a number of individualized programs and services to help patients and their families face the challenges associated with diagnosis and treatment.

Survivorship and Support Group Programs

Cleveland Clinic Florida offers access to groups and programs to help patients and family members deal with the variety of physical and emotional issues that may arise during cancer treatment.

Appearance Counseling

Cleveland Clinic Florida offers free services to patients undergoing cancer treatment to help them deal with appearance-related side effects.

For more information, call 954.689.5393.

Psychosocial Services

Social worker

Our social workers are licensed professionals, skilled in addressing the counseling, support and advocacy needs of patients and their families. Our mission is to reduce the social and emotional obstacles to healthcare resources and information.

Counseling can help you or a loved one:

  • adjust to the diagnosis of cancer
  • communicate with family members and doctors
  • cope with changes in self-image
  • access crisis intervention
  • find caregiver support
  • arrange for grief counseling
  • gain referrals to other mental health providers

We can provide you with

  • referrals to community resources
  • confidential outreach from a cancer survivor
  • referrals for spiritual support, nutrition counseling and complementary therapies
  • referrals for home health care, palliative care and hospice

Advocacy helps you and your family

  • navigate the health care system
  • address financial, insurance, disability and employment concerns
  • access needed prescriptions
  • explore transportation options
  • arrange school intervention for adults or children
  • discuss advance care planning--living will/durable power of attorney for healthcare

If you have an issue you would like to discuss or you would like to meet with a social worker, please call: 954.689.5393.

Dietitian

Registered dietitians and dietetic technicians are an integral part of our interdisciplinary team. A dietitian will work with you and your physicians to address your dietary needs during treatment, and prevent malnutrition if there are times of prolonged sickness.

Nutritional Counselor

Nutritional counselors analyze your health needs in regard to diet and exercise and help you set achievable health goals as you manage your disease. Nutritional counseling can help you:

  • increase energy
  • reduce symptoms of disease
  • strengthen your immune system
  • improve quality of sleep

Resource Center/Education Center

Our Patient Resource and Education Center provides patients and their friends and families information and resources about cancer.

Information available includes:

  • pamphlets and informational brochures
  • computer terminals that can be used for conducting internet searches
  • WiFi access for laptops
  • conference area where you can sit with a nurse and ask questions
  • listings and registrations for support groups and other patient programs
  • listings of resources such as wigs, transportation, and lodging

The Patient Resource and Education Center is open to help you obtain cancer information from 8 a.m. - 4:30 p.m., Monday - Friday.

American Cancer Society Participation

Cleveland Clinic Florida continues to play an active role in supporting the American Cancer Society’s community outreach efforts to raise awareness about cancer prevention, research, education and support services.

Cancer Registry

The Cancer Registry plays an integral role in the success of the Cleveland Clinic Florida Cancer Program, providing data management services to meet mandatory state cancer reporting requirements, as well as those of the American College of Surgeons Commission on Cancer. The Cancer Registry maintains data on all cancer patients and the data is made available to the medical staff for special studies, audits and research.

Smoking Cessation

Cleveland Clinic Florida’s Smoking Cessation Program uses the S.M.A.R.T. Quit approach to help patients overcome nicotine addition. The S.M.A.R.T. approach is as follows: Strategy: Develop a program tailored for each patient’s success. Motivation: Encourage patients to make a pact with themselves to keep trying. Awareness: Teach patients about nicotine addiction, withdrawal and triggers. Reasons: Help patients compare pros and cons and identify their top reasons to quit. Tobacco-Free Life: Help patients set a date; then commit to living without tobacco.

What to Bring to Your First Appointment

To ensure that your first visit to Cleveland Clinic Florida goes smoothly, please refer to the checklist below for a list of materials to bring with you:

  • Please have all insurance information, including health insurance and prescription insurance cards available.
  • Please arrange to have all the following medical documents:
  • Operation reports including biopsies or prior chest surgery
  • Pathology reports and actual pathology slides
  • Radiology reports and actual diagnostic films – (Chest CT Scans, Whole Body PET-CT Scans, and Chest MRI Scans. Please get copies of these radiology films on a CD in the proper DICOM format.
  • Other doctor notes that may include information regarding other medical conditions you may have.
  • A list containing the dosages and frequency of both prescription and non-prescription medications including vitamins, nutritional supplements, herbal products, and over the counter medications.
  • Name and address of your referring physician, primary-care physician and any other physicians you would like to receive the Lung Cancer Center physician's report.
  • If a physician has referred you, please be able to describe how your current diagnosis (if any) was made and the types of cancer treatments that you have already received.